来源：风湿病与关节炎,2018,7（5）:5-10,15.

系统性红斑狼疮的共病及其共存心血管相关疾病

危险因素的初步分析（临床研究）

董　琪^1,2，李振彬¹，刘　旭^1,2，张旭飞^1,3，牛雪敏^1,2，刁玉晓^1,3，周　岩¹

　　【摘　要】目的：分析系统性红斑狼疮（SLE）患者共病的临床分布特征及共存心血管相关疾病的危险因素，为我国SLE患者共存心血管相关疾病的防治管理提供参考。方法：选取2016年1至2016年12月在中国人民解放军白求恩国际和平医院风湿免疫科住院确诊的SLE患者94例，记录患者的一般资料、实验室检查结果及其共存慢性疾病的共病信息等，统计SLE患者共病分布情况，Logistic回归分析SLE共存心血管相关疾病的危险因素。结果：94例SLE患者中88例（93.62%）存在共病现象，涉及47种慢性疾病，共病患病率较高者包括高脂血症（35例，37.23%）、高血压（32例，34.04%）、冠心病（17例，18.09%）等。Logistic回归分析显示：高疾病活动度是SLE患者共存高脂血症的相对危险因素（OR = 1.076，P < 0.05）；高龄是共存高血压的相对危险因素（OR = 1.081，P < 0.01）、低水平球蛋白为其相对保护因素（OR = 0.920，P < 0.05）；高水平高密度脂蛋白及高抗凝血酶-Ⅲ活性是共存冠心病的相对危险因素（OR = 4.324、1.036，P < 0.05）。结论：SLE患者共病患病率高，涉及以心血管相关疾病为主的多种慢性病，其危险因素主要与SLE疾病活动度及其免疫异常有关。

　　【关键词】　系统性红斑狼疮；共病；心血管相关疾病；危险因素；Logistic回归分析

A Preliminary Analysis of the Multimorbidity of Systemic Lupus Erythematosus and the Risk Factors of Coexistence of Cardiovascular Disease

DONG Qi,LI Zhen-bin,LIU Xu,ZHANG Xu-fei,NIU Xue-min,DIAO Yu-xiao,ZHOU Yan

　　【ABSTRACT】Objestive:A preliminary analysis of the clinical distribution of multimorbidities in patients with systemic lupus erythematosus（SLE）and the risk factors for coexistence of cardiovascular-related diseases provides a reference for the management of cardiovascular disease in China.Methods:Select 94 cases of SLE patients diagnosed in the Rheumatology Division of Bethune International Peace Hospital from January to December of 2016,and record the general information of the patients,the results of the laboratory auxiliary examination and the multimorbid information of the coexistence of chronic diseases,etc.Distribution,Logistic regression analysis of risk factors for multimorbid SLE.Results:Among 94 patients with SLE,88（93.62%） had multimorbidity and involved 47 chronic diseases;those with higher multimorbidities included hyperlipidemia （35 cases,37.23%）and hypertension（32 cases,34.04%）,coronary heart disease（17 cases,18.09%）and so on.Logistic regression analysis showed that high disease activity was a relative risk factor for hyperlipidemia in SLE patients（OR = 1.076,P < 0.05）;senior age was a relative risk factor for coexisting hypertension（OR = 1.081,P < 0.01）.Low-level globulin was its relative protective factor（OR = 0.920,P < 0.05）;high-level high-density lipoprotein and high anti-thrombin-III activity were relatively risk factors for coexistence of coronary heart disease（OR = 4.324,1.036,P < 0.05）.Conclusion:The prevalence of multimorbidities in patients with SLE is high,and it involves a variety of chronic diseases with cardiovascular-related diseases.The risk factors are mainly related to SLE disease activity and immune abnormalities.

　　【Keywords】 systemic lupus erythematosus;multimorbidity;cardiovascular related diseases;risk factors;logistic regression analysis